Maternity care in the UK

I’m 35 weeks today! In lieu of a silly profile shot of myself and a boring update on my textbook pregnancy, I will share a few tidbits about maternity care and delivery here in the UK as I currently understand it.

In general they assume you will have a normal pregnancy unless something indicates otherwise. As far as testing goes I have had two ultrasounds (at 12 and 20 weeks) and maybe 4 blood tests (all looking for iron levels and such). At the 20 week ultrasound they did a nuchal fold measurement which gives some indication of risk of Down’s Syndrome. This is optional though.

If everything is ‘normal and healthy’ your care is midwife led. I have not seen an OB-GYN at all during the pregnancy. I have seen my GP (regular doctor) for a few of my regular check-ups.

You can choose where you have your baby

Hospital – attended by OB-GYN

Midwife unit at the hospital – attended by midwives – no epidurals here

Midwife unit in the community – 60 min ambulance ride if you need a doc

Home – attended by midwives. Yes, you can choose to have your baby at home

For options 3 or 4 you have to have NO indications of challenges. (no breech, no high bloodpressure, etc)

The hospitals are way less posh. You have to bring all your own things for you and the baby and dad’s don’t get to stay overnight.

‘Laughing gas’ is widely used for pain relief in labour and delivery. (they call it ‘gas and air’) Not sure if and when this was widely used in L&D in the States.

Epidurals are much less automatic (at least compared to insured Americans) and they encourage you to be up and mobile during labour.

(I find this part absolutely brilliant!) Once you have the baby the midwives come visit you in your home for your and the baby’s checkups. They come the day after you return home from wherever you had the baby then 3 or more times after that. They weigh the baby, do any needed tests and checks and if there are shots needed these are done at home. They also check on the mum at these visits. You don’t have to drag yourself or a one week old baby out for a checkup. They also make the visits to make sure that the baby’s environment is safe and can help with feeding problems or any questions you have.

Of course, a lot of these policies are financially driven. The national health service covers all maternity care at no out-of-pocket cost to the family, so to not bankrupt the country they have to do things differently. This has its pros and cons. Good in that they try to maximize the chances of a healthy mom and healthy baby (because problems ultimately cost more) and also good that they skip unnecessary procedures that may generate a profit in a fee-based system. It is a downside because sometimes those additional tests or procedures help in a number of cases – even when the averages don’t work out.

Since my pregnancy has been so textbook and there have been no indications of any problems I am seeing that side of it. If problems are evidenced it seems that the care ratchets up quite quickly. I have no concerns that I wouldn’t receive everything I needed if something did start to go wrong. I’ve just been lucky to not find out.

7 responses to “Maternity care in the UK”

My cousin-in-law in Canada also got two ultrasounds and that’s it. Since the baby wasn’t polite enough to show the goods during the second test, they won’t know whether it’s a boy or a girl until the baby is born. (Or if they decide to shell out for a private ulstrasound, which is unlikely.) It’s interesting to compare health care coverage between a nationalized system and the US profit-driven system.

Good post! I wish that American women were more informed about their options. If you have out of hospital midwifery care in the sates (like we did) you midwife also does the postpartum visit at your home. It is very nice. And they are right on with discouraging the epidural, movement during labor is extremely important and epidurals carry a huge list of risk factors with them, they are inherently dangerous and like most medical interventions should not be used unless they are really truly needed. I hope you enjoy the laugh gas (not allowed in the US) and I look forward to a full account of the labor and delivery : )